Invasive fungal sinusitis with basilar stroke
This elderly man presented with a brainstem stroke (see DWI). A mass is located in the sphenoid sinus eroding through the clivus and into the pre-pontine cistern.
The mass is isodense to grey matter on CT with only slight peripheral enhancement. On MRI it appears isointense to grey matter on both T1 and T2 sequences without central enhancement.
Features are consistent with an aggressive invasive fungal infection. He unfortunately passed away 48 hours after admission.